Chronic Prostatitis/Chronic Pelvic Pain Syndrome Is Often Confused With IC

Millions of men are believed to be struggling with prostatitis, a painful condition that involves inflammation of the prostate and sometimes the areas around the prostate. There are four variants of prostatitis which share some common symptoms including: urinary frequency, urgency, pain during urination in the penis or urethra, difficulty starting urination, flow irregularities, painful ejaculation, feeling as if the bladder is not fully emptied after urination, pain in the lower back, lower abdomen, above the pubic area, or between the testicles and rectum.

#1 – Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

The most common type of prostatitis, these patients struggle with inflammation in the prostate and irritation of the nerves. No infection is involved. Both IC and CP/CPPS are considered part of Urogenital Chronic Pelvic Pain Syndrome (UCPPS) which is being studied by the National Institutes of Health funded Multidisciplinary Approach to the Study of Pelvic Pain (MAPP) Research Network.

CP/CPPS patients may fall into the same variants/subtypes/phenotypes as interstitial cystitis including: pelvic floor dysfunction, pudendal neuralgia, central sensitization and others. Another challenge facing these patients is that some clinicians don’t look past the prostate and into the bladder where, perhaps, Hunner’s lesions and/or bladder stones could be playing a role.

The vast majority of men that we work with report pelvic injury of some type prior to the onset of their symptoms. From professional football players to paratroopers, high school athletes to iron man athletes, simple tailbone fall to traumatic pelvic injury, it’s important that patients share this history with their clinicians so that a proper diagnostic review can be conducted including injuries to muscles, bony structures and nerves. Treatment is then broadened to include injury treatment and repair, particularly with the pelvic floor muscles. Anxiety, PTSD and stress are also viable treatment to help lessen their impact on pain intensity and duration.

#2 – Acute (Sudden) Bacterial Prostatitis

The symptoms of acute bacterial prostatitis come on suddenly and are severe. Men should seek immediate medical care.
These patients may also experience chills, fever, very painful burning during urination and trouble emptying the bladder.

#3 – Chronic bacterial prostatitis

These men struggle with a chronic infection that appears to come and go over time. Diagnosis is made based upon both urine and prostate fluid cultures.

#4 – Asymptomatic Inflammatory Prostatitis

These patients have no symptoms but struggle with inflammation of the prostate. It is usually found accidentally during other examinations. Patients with prostatitis may try a wide variety of therapies. For bacterial prostatitis, antibiotics are always used. Anti-inflammatories, biofeedback, self help, diet modifications may also be suggested. And for men unresponsive to therapy or who are worsening over time, the consideration of other potential disorders such as pelvic floor or bladder injury should be considered.

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